Our Mission:

To be the most trusted, responsive and personalized partner of revenue cycle integrity, auditing, compliance, staffing, talent, coding, compliance and educational services in healthcare organizations across America.

Stay Up to Date:

Webinars

The Latest Events, Publications and News Stories Across Our Business and Industry

Free Live Webinar

Join us in this free live webinar event as our expert presenter panel cover the crucial areas to get right in overcoming clinical and technical denials.

DATETue, Sep 26, 2017 11:00 AM PDT / 2:00 PM EST

COST:
Free

DESCRIPTION:In this webinar, we will explore some key elements in reducing the potential for technical and clinical denials. Specifically, we will focus on:

Technical/Coding denials : we will review frequent reasons for coding and technical denials with tips that will help the facility to win on appeal.

Readmission denials: we will examine the definition of a readmission according to CMS and major payer policy guidelines. We will also discuss winning appeal strategies when tackling these difficult denials

Nadia has over 36 years of extensive professional nursing and healthcare experience, and is recognized as a technically astute and perceptive leader in providing practical solutions in Denial & Appeals Management. She has extensive expertise of InterQual/MCG guidelines, payer specific policy guidelines, medical necessity criteria, and knowledge of applying inpatient vs. observation levels of care, physician documentation requirements, and current CMS regulatory reforms.

Kay Hartley (RN, CCS, CCS-P)

Vice President of Quality Assurance

Kay has over 35 years of clinical experience working as a registered nurse and over 20 years working in the coding, quality assurance, auditing, education and DRG management fields. She has consulted with major Health Systems and Physician Practice Plans throughout the country.

Tricia M. Gilbert (RN, BSN, JD)

Assistant Manager of Clinical Appeals

Tricia has been a Registered Nurse for 16 years and a licensed attorney for 9 years. Most recently, she managed the Clinical Appeals Department for a large hospital system for the past 7 years. Her focus for the last 7 years has been solely on Claim Denials and Clinical Appeals and her expertise spans all levels of Governmental and Commercial appeals.